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"Annals
of Parenthood
Sleeping with the Baby
Which Side of the Bed Are You On?
The Author and His Wife Defied the Experts."
John Seabrook
First
published in the Nov. 8, 1999 issue
of the
New Yorker Magazine
(Reprinted with permission of author)
I am a co-sleeper. That is, my wife and I sleep with our ten-month-old
son, and we've been sleeping with him since he was born. This
puts us on the wrong side of the federal government's recent edict
about co-sleeping, which is that parents should never sleep with
children younger than age two. "Don't sleep with your baby or
put your baby down to sleep in an adult bed," stated Ann Brown,
chairwoman of the United States Consumer Product Safety Commission,
announcing the results of an eight-year study sponsored by her
agency, published in October in the Archives of Pediatrics and
Adolescent Medicine. As a co-sleeper, I wondered, on reading her
remarks in the newspaper, after another night in the sack with
the boy, what does sleep have to do with consuming product? Sleep
is one of the secret channels by which parents communicate with
their kids-under the radar, one hopes, of commercial influence
and government control. The Consumer Product Safety Commission
is the federal agency built at the intersection of those interests.
As a father, I was ambivalent about the announcement. Ten months
ago-at the other end of the long, dark tunnel of sleeplessness
that is new parenthood-I was firmly against co-sleeping. Had the
study been available then, I'm sure I would have welcomed it as
ammo for the argument I was having with my wife about how to put
our baby to sleep. Like many fathers, I didn't like the idea of
sleeping with the baby. Since we had prepared a bedroom for him,
and filled it with C.P.S.C.-approved products, I thought he should
use it. But I didn't really have a choice about where the baby
slept. The bottom line was that my wife favored co-sleeping. Being
a father means lots of new responsibilities, but most of those
are easy to accept; what's hard to accept is your secondary role
in making key parenting decisions. Grudgingly at first, I adapted
to the family bed, and as I did my views about co-sleeping evolved.
What makes the commission's report particularly obnoxious is that
Americans are prone to believe the advice of in-stitutional authorities
when it comes to parenting. And sleep is, of all the issues new
parents face, the most complex. A 1995 study conducted in the
Boston area by Sara Harkness, Charles Super, and Constance Keefer
found that more parents seek advice on how to get their children
to sleep than on any other health or behavioral subject. Science,
culture, and gender politics all play a role in the discussion-matters
that are hard enough to think about when you're rested, let alone
when you're sleep-deprived.
The science on which the C.P.S.C.'s declaration was founded is
very shaky. The agency's position was based on a single survey,
conducted over an eight-year period by Dr. Suad Nakamura, which
identified five hundred and fifteen U.S. infant deaths in adults'
beds, a hundred and twenty-one caused by "overlaying"-one of the
adults rolling over on the baby-and the others by entrapment in
the bedding (water beds accounted for seventy-nine of the deaths).
The study made no attempt to measure the relative statistical
significance of these five hundred and fifteen infant deaths-an
average of sixty-four a year-out of 3.9 million babies born annually
in the United States. If the decision about where a baby should
sleep is purely a matter of the child's welfare, the evidence
suggests that co-sleeping is marginally safer than sleeping alone.
In this country, twenty-seven hundred and five babies died in
1997 of Sudden Infant Death Syndrome, far more than the five hundred
and fifteen infants who died in adults' beds over an eight-year
period. Most SIDS babies die while sleeping by themselves, in
their cribs. A series of studies performed by James J. McKenna,
a biological anthropologist at Notre Dame, suggest, he says, that
"solitariness may conspire with infantile deficits to increase
SIDS risks." SIDS is thought to occur when the baby goes into
such a deep sleep that he stops breathing; having the mother's
heartbeat and breathing nearby re-starts the baby's system. In
fact, ninety per cent of the world's parents sleep with their
children. "If you have a baby," McKenna says, "sleep close to
it."
As always, the baby's left eyelid is the first one to close.
It could just be a blink, but now the second eyelid is sliding
down, definitely heavier than a blink would be. The muscles around
the chin relax, and the head settles sideways. "Go, baby," I whisper.
"Go to sleep." But, just as I'm starting to work out the minimum
number of moves it will take for me to get up from the sofa and
put the baby down in his crib, he startles: his arms fly upward,
his fingers clutching the air in fear, and his eyes snap open,
staring at some dreadful image-definitely not the candy-colored
clown they call the sandman. Damn.
It's not that he won't sleep. The problem is that he doesn't
sleep when we sleep. At three months, the baby is a "polyphasic"
sleeper, meaning that he sleeps in six or seven bouts per twenty-four
hours, without distinguishing between night and day. His parents
are "monophasic" sleepers, who are used to sleeping in one seven-
or eight-hour chunk at night. Teaching the noble savage what adults
mean by sleep is the first great challenge all parents face. Sleep
is the beginning of culture-our first attempt to pass our habits
along to our children. Sleep is also the beginning of moral judgments,
both about the baby (Is he a good sleeper or a bad sleeper? everyone
wants to know right away) and, more searchingly, about one's own
ability as a parent. His sleep, or lack thereof, is a comment
on our ability to provide contentment and peace; it seems articulate
in a way that his cries and grumbles and cooing do not, perhaps
because sleep is one of the few states that we have in common
at this point. It's a universal language that we share at a level
deeper than words. My wife comes in from the bedroom, literally
staggering with sleep deprivation. She listens to the baby's bleating
and divines that it is his "tired" cry, as opposed to his hungry
cry or his pained cry. I say, "He's not tired. We're tired. That's
the problem."
She stretches her arms out toward the baby, meaning, Give him
to me and I'll take him to bed. I say, "Wait." At this point,
I am still a believer in putting kids into their own beds as early
as possible, so that they can learn how to get to sleep by themselves,
even if it means letting a baby cry in his crib until he realizes
he's going to be fine. Piled around us on the sofa where we sit
with the baby are the parenting books from which my argument against
co-sleeping is derived: Benjamin Spock's "Baby and Child Care,"
T. Berry Brazelton's "Touchpoints," Burton L. White's "The New
First Three Years of Life," Arlene Eisenberg's "What to Expect
the First Year," and Penelope Leach's "Your Baby and Child." My
mother-in-law, who is living with us during these early months,
wonders why we bother with all these books. But we are more inclined
to trust books than family members. Grandmother is cherished for
her love and her willingness to hold the crying baby, but her
methods are suspect, because they are based on tradition and not
on information.
Spock says don't sleep with the baby after six months, unless
you want the baby sleeping with you for years. "What to Expect"
recommends leaving them in their cribs and letting them cry it
out for as long as you can stand it, an hour or more. "In our
society," Brazelton writes, "to be able to sleep alone in childhood
is part of being an independent person." White writes ominously,
"You can certainly do it"-i.e., co-sleep-"but I can't help you
with the complications the practice usually leads to." Even Leach,
the most permissive of the major experts (and the only female),
doesn't endorse co-sleeping: "Once your baby is, say, three or
four months old, it is sensible to make sure that she sometimes
goes to sleep on her own so that she knows how to do it." Leach
also points out that if your child needs to be with you to fall
asleep, you'll have to go to bed when he goes to bed, or you'll
have him on your lap or sleeping on the sofa next to you until
you're ready to turn in for the night.
Sounds sensible to me, but my wife was deeply suspicious of the
male-dominated rule-makers of child rearing. She resented these
authorities' trying to prevent her from doing what was intuitive
to her, which was to nurse the child to sleep in bed. To her,
this synod of experts who sit in permanent convention on our coffee
table was a textbook case of "hegemony." The co-sleepers also
have texts, and we own most of them: "The Family Bed," a Betty
Friedan-like manifesto written by Tine Thevenin, a stay-at-home
mom, in the nineteen-eighties (and featuring a blurb from Jane
Goodall that reads, "Western Society is wrong in putting a social
taboo on children sleeping with their parents"); "The Womanly
Art of Breastfeeding," by La Leche League International, which
advocates breast-feeding and is also a hotbed of co-sleepers;
and "Nighttime Parenting," by Dr. William Sears, a San Clemente
pediatrician. Sears, a Christian who supports the kind of sleeping
arrangements most Christian writers on child care oppose, is an
intriguing character; together with his wife, Martha Sears, a
La Leche League leader, he raised eight kids in a king-size bed.
His book is persuasive when he describes co-sleeping as part of
the larger philosophy of Attachment Parenting, an approach to
child rearing that posits the unity of the family rather than
the child's independence as the crucial goal of parenthood. But
there's a certain New Ageyness in Sears's writing which grates
on my post-sixties sensibility; for example, he's not above using
a word like "hormoneous" to describe his theory of how sleep-sharing
between mother and child puts their endocrine systems in synch.
Not one of the anti-co-sleeping authorities gives any really
compelling reason that kids should sleep on their own, other than
the parents' convenience. Most give lip service to the notion
that it is important for babies to sleep by themselves in order
to develop a sense of "independence." But independence is a notoriously
slippery concept: does it mean autonomy, self-reliance, or solitary
confinement? And, as the co-sleeping advocates point out, sleeping
alone may mean merely switching dependence from the parents to
objects in the crib-pacifiers, blankies, Teddy bears, and Teletubbies.
Is there any actual scientific evidence that where the baby sleeps
matters to his future? A 1996 study conducted at the University
of Michigan showed that kids who sleep alone wake up fewer times
during the night than kids who sleep with their parents. Other
studies have suggested that mothers and babies who sleep together
eventually develop similar sleep cycles, which is why they tend
to wake each other up: they are both in light sleep at the same
time. That's interesting, but such studies don't answer the question
I really want answered as a parent, which is how my child's early
sleeping habits will affect his waking habits as an adult-whether
he'll ever get a good night's sleep, or be at work on time, or
keep a schedule, if we don't teach him the rules of sleep now.
Handing my wife the wide-awake baby, I say, "Well, what if he's
sleeping with us when he's five?"
And she says, "What if he is? I slept with my parents until I
was at least five."
What? This is a revelation:I married a co-sleeper. I do not come
from co-sleepers. I was put in my crib and left to cry it out,
more or less. I wanted to sleep in my parents' bed, and I remember
the delicious warmth and the feeling of safety the few times I
did. But my father made it clear that he wasn't thrilled to have
me in the bed; by three I was "getting too old for this." I developed
into a head-banger-I'd get on all fours and bash the top of my
head against the headboard. It was comforting, like listening
to punk rock sixteen years later. In the morning, when I ask Grandmother
if it's true that her daughter slept with her until she was five
or so, she indignantly denies it. "Oh no, that's not true at all!"
she exclaims. "We let all our children come into our bed when
they wanted to, but they always left by the time they were two."
As with Grandmother, one detects a distinct reluctance to come
clean about sleeping with the kids, which makes me think that
a lot more of it goes on than anyone realizes. Most pediatricians
I spoke to reported seeing more co-sleeping now than at any other
time in recent memory; some saw this as part of the same trend
that has led to longer time in diapers and longer use of the pacifier.
Also, many mothers work all day, and nighttime is the only extended
time that they have with their children. Michael Kaplan, a child
psychiatrist at the Yale Child Study Center, makes a related point:
that under the guise of soothing the child's fears of abandonment
the mother is soothing her own fears of separation. Single mothers
are more likely to sleep with their kids than married mothers
are, he told me, and he also knows of some mothers who sleep with
their kids when their husbands are away on business, without telling
the husband. "They say, 'It's our secret from Daddy.'"
If I volunteer that I myself seem to be a co-sleeper, then the
person I am talking to will often confess that he or she is a
co-sleeper, too. But you have to be careful: you don't know quite
how people will judge you when you admit that you're doing it.
It seems that the issue of where the children sleep is also about
class. The white-bread middle-class view tends to be that poor
people and immigrants co-sleep, while "proper" American families
sleep in separate bedrooms, because they can. (Interestingly,
there is less of a stigma against the practice among African-Americans;
in one study, only seventeen per cent of white Americans admitted
to co-sleeping, while fifty-seven per cent of African-Americans
said that they did it.)It's not a coincidence that the height
of anti-co-sleeping sentiment, in the fifties, coincided with
the explosion of postwar bedroom communities.
Of the newish fathers I have questioned about family sleeping
arrangements, the biggest reason for not wanting to share the
bed with the baby is that they won't be able to have sex with
their wives anymore. "Don't have sex when a child is in your room,
even if he is sleeping," cautioned the Boston Globe in a sidebar
to a 1997 sleep-related story, under the heading "Suggestions
for Parents,"and this seems like a sensible policy. Yet the practice
of co-sleeping invites a distinction in the primal taboo. At four
months, does the baby really care if you have sex while he's in
the bed? Chances are he'll sleep through it, but even if he doesn't
he'll probably think it's funny. And it is funny. (Thank you for
reminding us.) But then, at a certain point, you definitely want
to knock it off, right? At what point is that? Six months? Ten
months?
Since co-sleeping after a year or two does seem to mean that
you may be in it for the long haul, some co-sleepers advocate
setting up a special "sex room" in the house. The bedroom has
been made the site of two not always compatible functions: sex
and sleep. (Americans use "sleeping together" as a euphemism for
sex, borrowing lamely from the French, but our usage misses the
sexiness of simply curling up next to someone and taking a nap
together.) However, the sex room, while an interesting idea for
Ikea, isn't really practical for most parents in New York City.
We don't have enough space for the baby stuff, much less for a
sex room.
So we slept with the baby. But it wasn't as if we said, O.K.,
let's co-sleep, and then did it. That's not the way it works.
It starts with the decision to breast-feed. Co-sleeping is like
the fine print at the bottom of the breast-feeding contract. The
baby falls asleep at the breast around seven-thirty, and you put
him down in his crib. Maybe he wakes up again at eleven-thirty,
and you repeat the process. Then he wakes up at 2 A.M. Some really
committed parents continue to get up at this point, and nurse
the baby sitting up in a rocker in his room, but if the parents
are at all ambivalent the mother gets the baby and brings him
into bed, where she can at least lie down and doze while he eats.
As the father, you're not going to tell the exhausted mother that
she has to feed him outside of the bed. (And, if you do, you'll
also have to get up once in a while yourself to give him a bottle
of expressed breast milk.) But we didn't sleep well at all. After
four months of co-sleeping, the situation began to deteriorate.
His polyphasic habits did not seem to be shifting toward our monophasic
sleep. Instead, the opposite seemed to be happening: my formerly
unified block of sleep was now broken into two parts, according
to the baby's schedule, but, unlike him, I couldn't easily go
back to sleep once I'd been awakened at 3 A.M., and spent the
rest of the night in a hypnagogic state between sleep and wakefulness,
with surreal images drifting across my unrested brain. Then his
four-hour sleep phases shortened to two hours. Instead of sleeping
in his crib until 2 A.M. and coming into our bed, he was coming
in at midnight. He still seemed to be getting the sleep he needed,
even if he wasn't learning to do it by himself. My wife and I,
however, were beginning to exhibit symptoms of sleep deprivation:
the burning eyes; the band of fatigue that tightens around the
skull, a sensation some liken to the feeling that you're always
wearing a hat; the irritation-at each other, at friends, at the
cat's water bowl, which I kept kicking by accident; and astereognosis,
or the inability to recognize things by touch, which is a classic
sign of sleep deprivation. There was a sense of growing distance
between ourselves and the world. Did I go out this morning to
get the Times, or was that yesterday morning? I glance at the
weather report in the top right-hand corner of the front page,
and it says "Interesting clouds." Hmm. Interesting clouds. Never
seen that forecast before. Then I realize it says "Increasing
clouds." But "Interesting clouds" made perfect sense.
Baby's crying in his crib again. I try to focus on the big red-lettered
digital clock: 3:32 A.M. He almost invariably wakes up within
ten or fifteen minutes of the hour he was born (3:21 A.M.), which
has led to my primal-wakeup-call theory: that he is re‘nacting
nightly the trauma of being rudely rousted from the womb. My wife
fetches him and brings him back to the bed. She puts him on her
side, as she always does, and turns toward him, though sometimes
by morning he's been moved in between us. I lie there wide awake,
Father Time, while Mother Nature and her baby go at it next to
me, eating and giving life, in a deep rhythmic bond. My main job
is to avoid rolling over on my son. (Dr. Sears suggests that the
father be a "warm fuzzy" in bed and, by way of illustration, he
includes a picture of his own hairy-chested self, lying in bed
with one of his kids. But I'm not feeling much like a warm fuzzy
right now.)
Sleeping with babies is not like sleeping with adults. Babies
have a different agenda when they sleep, and they behave differently
in bed as a result. Infants are in REM sleep-the so-called rapid-eye-movement
phase of sleep, which is associated with dreaming-twice as much
as adults are. Thirty-week-old human fetuses are in REM sleep
virtually all the time, newborns about half their sleep time.
Building on experiments performed on baby rabbits and cats, which
show that newborns prevented from REM sleep develop behavioral
difficulties as adults, sleep experts believe that REM sleep in
infants plays an important role in the structural development
of the brain. As the psychiatrist J. Allan Hobson has put it,
babies are literally "making up their minds" when they sleep.
Michel Jouvet, an eminent French sleep scientist, theorizes in
his recent book, "The Paradox of Sleep," that human infants are
born with crucial parts of their genome unfinished, and that the
"genetic programming occurs during dreaming." We are all born
essentially the same, he argues, and babies' dreams help program
unconscious reactions that are the basis of individual personality.
Adults in REM sleep are paralyzed, presumably to prevent them
from acting out their dreams. Babies aren't paralyzed (where exactly
are they going to go?), so they move around a lot more at night.
They twitch, squirm, bicycle, grumble, smile, head-butt, thrash,
and make weird half-laughs: it's almost as if they were awake.
(Indeed, the brain waves of an infant in REM sleep hardly differ
from his waking alpha waves.) All this activity was fine when
Baby was tiny, but now that he's growing the dreaming baby's presence
in our bed is not conducive to our getting the sleep we really
want, which is deep, or delta-wave, sleep: the big slow rollers
you see on the EEGs, which are caused by billions of neurons firing
at once. It is during delta sleep that the neurotransmitters which
are important to making sleep feel refreshing, such as acetylcholine
and serotonin, are released. Also, without deep sleep the pituitary
gland doesn't release as much human growth hormone, which is what
keeps the muscles toned. And you know what that means: Puff Daddy.
The depths of my sleep deprivation happened to coincide with
the second annual Sleep Awareness Week, which is the National
Sleep Foundation's attempt to get people to take sleep deprivation
more seriously as a health risk. The Exxon Valdez spill, Chernobyl,
and the Bhopal disaster all happened at the hands of sleep-deprived
workers. Auto fatalities are more likely to be caused by the sleepy
than by the drunk, but because there is no stigma attached to
sleep deprivation-indeed, it is often considered a sign of virtuous
hard work-few blame the sleepless drivers. (In one recent poll,
cited by William C. Dement in his new book, "The Promise of Sleep,"
twenty-three per cent of drivers admitted to falling asleep at
the wheel at least once a year.) People who would never tolerate
a pilot or a surgeon who has been drinking often put themselves
in the hands of one who hasn't slept for twenty-four hours. In
his recent book, "Sleep Thieves," Stanley Coren writes that each
year sleep-related errors and accidents cost the United States
over $56 billion, cause nearly twenty-five thousand deaths, and
result in almost two and a half million disabling injuries. But
the ethos of sleep deprivation may be changing. One could take
heart from a recent story in the Wall Street Journal which reported
that the founder of Amazon.com, Jeff Bezos, and the president
of Netscape, Marc Andreessen, two of the builders of the twenty-four-hour
world, proudly boast of sleeping eight hours or more a night.
Montaigne records that the ancient Romans killed King Perseus
of Macedonia by keeping him awake, but in modern times no human
is known to have died from lack of sleep. In 1959, Peter Tripp,
a popular d.j. on WMGM, in New York City, stayed awake in a booth
in Times Square for two hundred and one hours, to raise money
for charity. He experienced delusions and paranoia, and, at the
end, when a doctor in a dark suit was examining him, Tripp thought
the man was an undertaker preparing to bury him alive and fled
the room screaming. In 1965, Randy Gardner, a seventeen-year-old
high-school student in San Diego, stayed awake for two hundred
and sixty-four hours, and, according to Dr. Dement, who played
pinball games with Gardner toward the end of his vigil, showed
no hallucinatory behavior or adverse effects, other than being
really, really tired (and he won all the games). Both Tripp and
Gardner recovered from their ordeal with one long sleep. Animals,
however, have died from lack of sleep. In the classic book "Sleep
and Wakefulness," Nathaniel Kleitman clinically reports killing
puppies by keeping them awake (it took five to six days), and
other researchers have deprived adult dogs of sleep until they
died (that took thirteen days). But the most famous of all sleep-deprivation
experiments on animals was performed by Dr. Allan Rechtschaffen,
a now famous sleep researcher in Chicago. He placed two rats,
both wired to an electroencephalograph, on a revolving circular
platform, separated by a barrier. As soon as the EEG showed that
the designated sleep-deprived rat was falling asleep, the platform
would begin to tilt, and the rat would be plunged into cold water,
or, in other experiments, smacked against a wall. (The control
rat was allowed to fall asleep.) The sleep-deprived rats developed
sores on their feet, and ate two and a half times as much as they
normally did, but still lost weight-it was as though their sped-up
metabolisms consumed them. All the sleepless rats died within
twenty-one days. However, extensive autopsies revealed no cause
of death. The rats simply died. Finally, sleep and death-Hypnos
and Thanatos, who were twin brothers in Greek mythology-were united
in the absolute perfect moment of drifting away.
"Dr. Ferber saved my life." More than one parent has said something
like this to me about Dr. Richard Ferber's theories on sleep,
and by the time our baby is five months old I am ready to believe
them. "We put her in the crib," one male friend of mine said,
"closed the door, and basically had to tie ourselves to the bed
to stop from going in. When the crying finally stopped we looked
in and our daughter had actually stuck her head through the bars
and gone to sleep. But it worked in two nights."
First published quietly with a small printing in 1985, Ferber's
"Solve Your Child's Sleep Problems" has to date sold about seven
hundred and fifty thousand copies, and currently sells more than
fifty thousand copies a year. According to Fred Hills, Ferber's
editor at Simon & Schuster, people buy multiple copies to give
to friends who are new parents. (It's a "you have to read this"
book.) Anyone who doubts that sleep is a highly politicized issue
should try dropping Ferber's name at a parenting group and gauging
the polarized reaction. To a committed co-sleeper, Ferber is the
enemy, because he brings cold methodology-what Lewis Mumford once
called "technics"-to the enchanted and still largely uncolonized
kingdom of sleep. But to a sleepless parent in urgent need of
help, Ferber is indeed a savior.
The most famous part of the book is an incremental chart that
lays out Ferber's step-by-step method of getting a child to go
to sleep by himself. On the first night, you place the baby in
his crib, close the door, and don't re‘nter for five minutes.
The second night you wait ten minutes, the third night fifteen,
and so on, until by the seventh night you're waiting thirty-five
minutes. (There's something sort of Biblical about it all.) The
child cries, the agonized parents stand outside the door, desperate
to go in and stop the crying-but not, Ferber says, until "time's
up." Under certain circumstances you can go in and comfort your
angel, and perhaps pat him a little, but even if the child cries
so hard he throws up you are not to pick him up from the crib.
"Clean him up and change the sheets and pajamas as needed," Ferber
writes, "and then leave again." If you can stand this, you will
be rewarded with a child who is "Ferberized"-i.e., able to go
to sleep alone in his own bed. It sounds almost sadistic, and
yet for me the idea of solving this problem by an efficient, ingenious
method is very seductive. The appeal of Ferberizing springs from
the same place in the American character that delights in eliminating
dirt by "simonizing" the car, or ridding oneself of stains by
"mercurizing" the dry cleaning-a faith in salvation through method
that goes back to Ben Frank-lin's time-saving tips in "Poor Richard's
Almanac."
Families from all over the world go to the Center for Pediatric
Sleep Disorders, which Dr. Ferber runs at the Children's Hospital
in Boston, in search of answers to their kids' sleep problems.
Dr. Ferber or one of his senior fellows sees the family for one
two-hour session, with the sleepless child, and the center works
up a program for the parents, who try it and report back in two
to four months. In certain cases, Ferber will do a "sleep study"
on the child, which means the child spends the night wired up
in the sleep lab.
I met Dr. Ferber in early April, on a Friday, which is one of
the days when he is away from his clinical practice, seeing patients
at the lab. A sleepy child, with dark circles under his eyes,
was in one of the three sleep rooms. Outside the lab, a mother
was pulling a wagon in which her six-year-old was lying down,
a big pacifier stuck into her mouth.
Dr. Ferber is a slight, soft-spoken man, with a white Freudian-style
beard that makes him look older than his fifty-five years. His
reading glasses hang on a braided strap around his neck. He is
hardly as large as he looms in the sleepless parent's imagination.
He showed me around, demonstrating how he can simulate day and
night in one room by gradually turning up banks of lights. While
there was a certain crispness in Dr. Ferber's manner, a suggestion
that he likes a firm schedule for himself ("I absolutely cannot
be here after six," he told me, when we were making plans for
my visit), there was nothing about him that seemed sadistic.
Ferber was trained as a pediatrician, and initially had no special
interest in sleep. In medical school he conducted a research project
on biorhythms in mice, through which he became more interested
in sleep rhythms. And that has been the emphasis throughout his
career-understanding the extent to which sleep is actually a matter
of clockwork, or habit. At the heart of Ferber's approach to sleep
is his theory of "associations." In his book he uses the example
of a pillow. Just as an adult gets into the habit of falling asleep
with a pillow, and should he wake up and find his pillow missing
can't get back to sleep until he finds it, so the baby needs whatever
he first associates with sleep in order to get to sleep. If it's
a breast, or the parents' bed, then he will need that, and nothing
else will do. If the parents pick the child up from his crib each
time he cries, he will associate crying with comfort. Ferber's
theory of associations resembles the ideas of the Russian scientist
Ivan Pavlov, who won a Nobel Prize for his work on conditioned
reflexes in dogs but who spent years trying to prove similar ideas
about sleep-that sleep was brought on by the inhibition of certain
areas of the cerebral cortex, and that the inhibition was a conditioned
reflex. Pavlov's ideas were criticized by Kleitman in "Sleep and
Wakefulness," and they are no longer accepted as theories to explain
the physiology of sleep. But, as an aid to getting to sleep, Ferber's
Pavlovian approach-that children can be trained to sleep just
as animals can be trained to salivate at the ringing of a bell-seems
to work.
It had started to rain, and the gloom seeped into the corners
of the odd, triangle-shaped room where we were sitting. Ferber
was saying that he became interested in applying what he knew
about sleep rhythms to children in the early seventies, when he
was a new parent. "Both our kids stayed in the room with us when
they were babies," he told me, "and they'd wake up and have to
be rocked to sleep again. I didn't understand why they were waking
up. I do now-it was because they didn't know how to get to sleep
on their own." Slowly, using a crude version of what would become
his famous method, Ferber weaned the kids from his and his wife's
bed; they were the original Ferberized children. Ferber does not
like the word "Ferberize." "It's like it's a diet," he told me.
"It makes it seem like that's all my work is about-that chart-whereas
the whole purpose of our work here at the center is to come up
with a solution that is right for each child's sleep problem.
When you look at a sleep problem, you have to take everything
into account-the age of the child, the sleeping situation, the
parents, whether the bedrooms are next to each other. There are
situations where that chart works, but it doesn't work for everyone.
When I get a letter that says, 'We've been using your technique
for six weeks and he cries all night'-I think that's horrible.
That's very cruel." I confessed to Dr. Ferber that we were sleeping
with our baby. "We bring him into our bed, or my wife nurses him
to sleep and then puts him down-anyway, he almost never goes to
sleep on his own. And I'm worried that he's going to get in the
habit of it...." I trailed off guiltily.
Dr. Ferber's voice was reassuring. "Well, several things could
happen. He might settle at around six months and start sleeping
better. Then you've got no problem, if you're happy with the co-sleeping.
Or his problems might persist, and the longer they go on the harder
it will be to overcome them. At any rate, he's still young enough
that you've got some freedom to decide what you want to do. Because
either co-sleeping or putting him in his crib can work." "But
it says here in your book..." I read him two sentences I had read
to my wife during one of our 2 A.M. showdowns: "Although taking
your child into bed with you for a night or two may be reasonable
if he is ill or very upset about something, for the most part
this is not a good idea." And, "Sleeping alone is an important
part of his learning to be able to separate from you without anxiety
and to see himself as an independent individual."
"I wish I hadn't written those sentences," Ferber replied. "That
came out of some of the existing literature. It is a blanket statement
that is just not right. There's plenty of examples of co-sleeping
where it works out just fine. My feeling now is that children
can sleep with or without their parents. What's really important
is that the parents work out what they want to do." Back at Logan
Airport to catch the shuttle, I called home from a pay phone.
"Guess what. Ferber recanted."
"He recanted?"
"He says he's sorry he ever wrote those words about how co-sleeping
in-terferes with the kid's independence."
"Really? Wow."
I was thinking that now my last line of defense had fallen and
we would be sleeping with the baby forever. But instead, once
my wife understood that Ferber wasn't telling her that she couldn't
sleep with the baby, she became more interested in what he had
to say. The following week, she asked me where that Ferber book
was, and not long after that we tried a modified version of the
chart-and failed miserably. It turns out that not every child
is Ferberizable: as Ferber himself had pointed out, some just
keep crying. And some parents aren't Ferberizable, either: they
can't bear to hear their baby cry. When we reached the thirty-five-minute
mark-he was still howling his head off and we were simply wrecked-we
gave up. Maybe it was because it was too late to go back: by now
he'd been sleeping with us for six months, and we were all starting
to get conditioned. What if we'd tried it earlier?In any case,
it didn't work, and none of the books, including Ferber's, talk
about what to do next.
If we couldn't change our little polyphasic's habits, the question
became: Could we change ours?How much sleep do adults really need,
and what form should it take? I asked Dr. Neil Kavey, the director
of the Sleep Disorders Center at Columbia-Presbyterian, whether
it is possible for an adult to adjust his internal clock to match
a baby's clock-for a monophasic to change into a polyphasic. Kavey
said that he wouldn't advise it, but he does know of a similar
condition, which he has named "writer's syndrome." As a sleep
doctor in Manhattan, he sees a lot of this. "Young people come
to the city to be artists or writers or what have you-creative
types. Because they have no fixed schedule, they tend to stay
up late, or perhaps all night, and sleep during the day. They
do this for so long that they actually reset their circadian clock.
But of course it's not easy to make it as an artist, and many
don't make it, and at some point they have to get day jobs. But
after years of staying up all night their clock has shifted, and
they can't stay awake during the day. Hence, writer's syndrome."
I also spent some time with recently published books by sleep
scientists, which, in addition to Jouvet's and Dement's books,
include "Dreaming Souls," by Owen Flanagan, a professor at Duke
University, and "The Enchanted World of Sleep," by Peretz Lavie.
The study of sleep, a synthesis of neurology, psychology, physiology,
and general practice, seems to attract scientists with a literary
bent, perhaps because a poet's gift for metaphor can win a sleep
scientist almost as much renown as a breakthrough in the lab.
Some of the most persuasive recent theories about sleep and dreaming
are also the most beautiful, such as Francis Crick and Graeme
Mitchison's notion that "we dream in order to forget"-that the
purpose of dreaming is to wash out the part of the day's sensory
intake that isn't useful, and fix in amber the stuff that is.
Without that necessary disk maintenance, they theorize, all the
random information flying around in our heads would drive us mad.
In "The Interpretation of Dreams," published in 1900, Freud claimed
sleep for the study of dreams, and dreaming for psychoanalysis,
thereby cutting the physiologists and neurologists out of the
field. The mechanistic study of sleep-sleep as measured by eye
movements and electrical impulses in the brain-did not get under
way until 1953, when the rapid-eye-movement phase of sleep was
discovered in Chicago by Nathan-iel Kleitman and his graduate
student Eugene Aserinsky, who observed it in his eight-year-old
son. That discovery, and Dement's linking of REM sleep to dreaming,
led to a thirty-year period of extraordinary interest in the field.
As Jouvet writes, "The whole domain of dream function, apart from
a few rear-guard actions, slowly quit the psychoanalyst's couch
to enter the neurobiologist's laboratory."
In the nineteen-sixties, the "monoamine theory" of sleep was
developed. According to this theory, the purpose of sleep is to
replenish neurotransmitters in the brain-those chemicals like
acetylcholine and seratonin, which are depleted in waking consciousness.
Jouvet isolated the part of the brain that triggers sleep, and
it was believed to be only a matter of time before the major REM
sleep inducers and inhibitors would be synthesized in the lab.
However, with the passing years other neurotransmitters were added
to the soup, and the monoamine theory became murkier. Today, a
complex mixture of neurotransmitters is thought to be involved
in our nighttime lives, and sleep scientists are still struggling
to understand how all of them work together. "Now we have dozens,"
writes Jouvet, "but to have dozens is like having none at all."
With a certain fin-de-si¸cle weariness, he calls the early excitement
over serotonin "a second-rate novel." At the same time, funding
for sleep science has shifted from basic research to "sleep medicine,"
which deals with more practical sleep problems, like insomnia,
narcolepsy, and sleep apnea. Most of the research funding comes
from drug companies; sleep medication is prescribed more often
than any other class of prescription drugs in the United States.
Sleep centers that prescribe medicine, like Dr. Kavey's clinic
at Columbia, have sprung up all around the country.
For many years, sleep was thought to be the opposite of wakefulness-rest
for the mind. But the prevailing trend in neurological studies
of sleeping brains is toward an active-mind theory of sleep. In
sleep there is only a twenty per cent decrease from waking neural
activity. Some neurons are resting-specifically in the parts of
the brain associated with attention and memory-but others are
firing away just as busily as when we're awake. J. Allan Hobson
writes in "The Dreaming Brain" (1988), "As many neurons are turned
on as turned off during sleep, and almost all the cells in the
brain are spectacularly active during REM sleep." He suggests
that the brain is "talking to itself" while we sleep. "Much more
than recovery from the wear and tear of today, tonight's sleep
may be an active and dynamic preparation for the challenges of
tomorrow." In an article published in the journal Neuroscience
in 1992, two professors of neurology, R. R. Llin‡s and D. Parˇ,
summarizing the state of research on sleep and dreams, wrote that
"wakefulness is nothing other than a dreamlike state modulated
by the constraints produced by specific sensory inputs." Wakefulness,
they added, is "one element in a category of intrinsic brain functions,
of which REM sleep is another element." The only difference between
waking and dreaming is that the former receives input from the
senses and the latter from the neurons. Subjectivity, Llin‡s and
Parˇ wrote, emerges out of "the dialogue between the thalamus
and the cortex"-two areas in the brain which, studies suggest,
communicate during sleep. "I think, therefore I am" should really
be "I dream, therefore I am"-but, then, Descartes's famous definition
of consciousness came to him in a dream.
Around eight months into sleeping with the baby, my sleep pattern
began to change. The turning point was my first night alone with
my son; his mother was away, and it was just the two of us together.
It was absolutely awful-he cried most of the night, rooting around
for breasts that weren't there, until eventually he fell asleep
on my chest, and I drifted off, too. After that night I wasn't
afraid of his nighttime self anymore, and the situation has been
getting better ever since. I will not go so far as to say that
we have become "hormoneous," but I now find that I can get the
rest I need, even if I wake up once or twice a night. It's a different
kind of sleep than I used to get, but I'm not as tired as I was
in the early months, and I dream a lot more. Perhaps the American
veneration for a night of unbroken sleep is another culturally
determined prejudice, posing as science. Here, if you're awake,
you're supposed to be busy with wireless communications. Sleep
is the only private time you've got left, and it's not surprising
that people tend to make a fetish of it.
I have enjoyed sleeping without the baby, on those few nights
when I have been away from home. Sleeping alone in a hotel bed,
I have had the kind of rest that now seems like a distant memory.
I am also hopeful that one day our son will want to sleep in his
own bed; even Ferber allows that this sometimes happens without
the parents' intervention.
But what I would miss is the sight of my son's face just as he
is waking up. First comes that moment of balance between sleep
and wakefulness, when the nighttime visions are fading from his
eyes (does he know he's been dreaming?) but nothing like real
wakefulness has registered yet. And then there is the smile, a
big radiant grin provoked by nothing more than the mere presence
of another day. It is remarkable to see a person wake up with
a big smile on his face each day-even if it is way too early in
the morning. I'm trying to figure out how he does it. ©
**********************
Reprinted with permission of the author, John Seabrook.
Seabrook is a staff writer at the New Yorker. His most recent
book is Nobrow, which has just been published in paperback by
Vintage
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